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Сердечно-сосудистая патология и COVID-19: кратко о главном
Сердечно-сосудистая патология и COVID-19: кратко о главном
Недогода С.В. Сердечно-сосудистая патология и COVID-19: кратко о главном. Consilium Medicum. 2020 (22); 5: 19–21. DOI: 10.26442/20751753.2020.5.200157
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Аннотация
В ситуации пандемии COVID-19 особую группу риска составляют пациенты с сердечно-сосудистыми заболеваниями (ССЗ), которые широко распространены в популяции. Сочетание COVID-19 и ССЗ создает дополнительные сложности в диагностике, определении тактики терапии, порядке маршрутизации пациентов. Ситуация осложняется дефицитом информации, зачастую противоречивыми данными и крайне высокой важностью решения ряда вопросов для клинической практики. Настоящий обзор посвящен наиболее важным аспектам, касающимся сочетания ССЗ и COVID-19. Рассмотрены механизмы патологического влияния COVID-19 на сердечно-сосудистую систему, эпидемиологические аспекты сочетания данных патологий в разрезе влияния на смертность пациентов, влияние коморбидной патологии на прогноз пациентов с COVID-19 в сравнении с другими респираторными вирусными заболеваниями, патоморфологические особенности изменения тканей при COVID-19, а также побочные эффекты, которые могут возникать со стороны сердечно-сосудистой системы при использовании препаратов для лечения пациентов с COVID-19. Помимо этого, обсуждены безопасность и целесообразность терапии статинами, ингибиторами ангиотензинпревращающего фермента, блокаторами рецепторов ангиотензина II или другими блокаторами ренин-ангиотензиновой системы на исходы у пациентов с COVID-19.
Ключевые слова: сердечно-сосудистые заболевания, COVID-19, респираторная вирусная инфекция, ингибиторы ренин-ангиотензин-альдостероновой системы, препараты для лечения COVID-19, патологоанатомическое исследование.
Key words: cardiovascular diseases, COVID-19, respiratory viral infection, inhibitors of the renin-angiotensin-aldosterone system, drugs for the treatment of COVID-19, pathoanatomical study.
Ключевые слова: сердечно-сосудистые заболевания, COVID-19, респираторная вирусная инфекция, ингибиторы ренин-ангиотензин-альдостероновой системы, препараты для лечения COVID-19, патологоанатомическое исследование.
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Key words: cardiovascular diseases, COVID-19, respiratory viral infection, inhibitors of the renin-angiotensin-aldosterone system, drugs for the treatment of COVID-19, pathoanatomical study.
Полный текст
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2. Kang Y et al. Cardiovascular manifestations and treatment considerations in covid-19. Heart 2020.
3. Badawi A, Ryoo SG. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis. Int J Infect Dis 2016; 49: 129–33.
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12. Yao XH et al. A pathological report of three COVID-19 cases by minimally invasive autopsies. Zhonghua bing li xue za zhi. 2020; 49: E009.
13. Xu Z et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020; 8 (4): 420–2.
14. Tian S et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies. Modern Pathology 2020; p. 1–8.
15. Fox SE et al. Pulmonary and cardiac pathology in Covid-19: the first autopsy series from New Orleans. Med Rxiv 2020.
16. Ng D. L. et al. Clinicopathologic, immunohistochemical, and ultrastructural findings of a fatal case of Middle East respiratory syndrome coronavirus infection in the United Arab Emirates, April 2014. Am J Pathol 2016; 186 (3): 652–8.
17. Alsaad KO et al. Histopathology of Middle East respiratory syndrome coronovirus (MERS‐CoV) infection – clinicopathological and ultrastructural study. Histopathology 2018; 72 (3): 516–24.
18. Lang ZW et al. A clinicopathological study of three cases of severe acute respiratory syndrome (SARS). Pathology 2003; 35 (6): 526–31.
19. Ding Y et al. The clinical pathology of severe acute respiratory syndrome (SARS): a report from China. J Pathol 2003; 200 (3): 282–9.
20. Farcas GA et al. Fatal severe acute respiratory syndrome is associated with multiorgan involvement by coronavirus. J Infect Dis 2005; 191 (2): 193–7.
21. Mehra MR et al. Cardiovascular disease, drug therapy, and mortality in Covid-19. N Engl J Med 2020.
https://scardio.ru/materialy_po_diagnostike__i_lecheniyu_pacientov__s_serdechnososudistymi__zaboleva...
[Materialy po diagnostike i lecheniiu patsientov s serdechno-sosudistymi zabolevaniiami v usloviiakh pandemii COVID-19.
https://scardio.ru/materialy_po_diagnostike__i_lecheniyu_pacientov__s_serdechnososudistymi__zaboleva... (in Russian).]
2. Kang Y et al. Cardiovascular manifestations and treatment considerations in covid-19. Heart 2020.
3. Badawi A, Ryoo SG. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis. Int J Infect Dis 2016; 49: 129–33.
4. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19). China, 2020. China CDC Weekly 2020; 2: 113–22.
5. Chan JWM et al. Short term outcome and risk factors for adverse clinical outcomes in adults with severe acute respiratory syndrome (SARS). Thorax 2003; 58 (8): 686–9.
6. Mertz D et al. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. BMJ 2013; 347: f5061.
7. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance
8. Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr 2020.
9. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med 2020; 1.
10. Zhou F et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020.
11. Wang D et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323 (11): 1061–9.
12. Yao XH et al. A pathological report of three COVID-19 cases by minimally invasive autopsies. Zhonghua bing li xue za zhi. 2020; 49: E009.
13. Xu Z et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020; 8 (4): 420–2.
14. Tian S et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies. Modern Pathology 2020; p. 1–8.
15. Fox SE et al. Pulmonary and cardiac pathology in Covid-19: the first autopsy series from New Orleans. Med Rxiv 2020.
16. Ng D. L. et al. Clinicopathologic, immunohistochemical, and ultrastructural findings of a fatal case of Middle East respiratory syndrome coronavirus infection in the United Arab Emirates, April 2014. Am J Pathol 2016; 186 (3): 652–8.
17. Alsaad KO et al. Histopathology of Middle East respiratory syndrome coronovirus (MERS‐CoV) infection – clinicopathological and ultrastructural study. Histopathology 2018; 72 (3): 516–24.
18. Lang ZW et al. A clinicopathological study of three cases of severe acute respiratory syndrome (SARS). Pathology 2003; 35 (6): 526–31.
19. Ding Y et al. The clinical pathology of severe acute respiratory syndrome (SARS): a report from China. J Pathol 2003; 200 (3): 282–9.
20. Farcas GA et al. Fatal severe acute respiratory syndrome is associated with multiorgan involvement by coronavirus. J Infect Dis 2005; 191 (2): 193–7.
21. Mehra MR et al. Cardiovascular disease, drug therapy, and mortality in Covid-19. N Engl J Med 2020.
________________________________________________
2. Kang Y et al. Cardiovascular manifestations and treatment considerations in covid-19. Heart 2020.
3. Badawi A, Ryoo SG. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis. Int J Infect Dis 2016; 49: 129–33.
4. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19). China, 2020. China CDC Weekly 2020; 2: 113–22.
5. Chan JWM et al. Short term outcome and risk factors for adverse clinical outcomes in adults with severe acute respiratory syndrome (SARS). Thorax 2003; 58 (8): 686–9.
6. Mertz D et al. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. BMJ 2013; 347: f5061.
7. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance
8. Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr 2020.
9. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med 2020; 1.
10. Zhou F et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020.
11. Wang D et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323 (11): 1061–9.
12. Yao XH et al. A pathological report of three COVID-19 cases by minimally invasive autopsies. Zhonghua bing li xue za zhi. 2020; 49: E009.
13. Xu Z et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020; 8 (4): 420–2.
14. Tian S et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies. Modern Pathology 2020; p. 1–8.
15. Fox SE et al. Pulmonary and cardiac pathology in Covid-19: the first autopsy series from New Orleans. Med Rxiv 2020.
16. Ng D. L. et al. Clinicopathologic, immunohistochemical, and ultrastructural findings of a fatal case of Middle East respiratory syndrome coronavirus infection in the United Arab Emirates, April 2014. Am J Pathol 2016; 186 (3): 652–8.
17. Alsaad KO et al. Histopathology of Middle East respiratory syndrome coronovirus (MERS‐CoV) infection – clinicopathological and ultrastructural study. Histopathology 2018; 72 (3): 516–24.
18. Lang ZW et al. A clinicopathological study of three cases of severe acute respiratory syndrome (SARS). Pathology 2003; 35 (6): 526–31.
19. Ding Y et al. The clinical pathology of severe acute respiratory syndrome (SARS): a report from China. J Pathol 2003; 200 (3): 282–9.
20. Farcas GA et al. Fatal severe acute respiratory syndrome is associated with multiorgan involvement by coronavirus. J Infect Dis 2005; 191 (2): 193–7.
21. Mehra MR et al. Cardiovascular disease, drug therapy, and mortality in Covid-19. N Engl J Med 2020.
Авторы
С.В. Недогода*
ФГБОУ ВО «Волгоградский государственный медицинский университет» Минздрава России, Волгоград, Россия
*nedogodasv@rambler.ru
Volgograd State Medical University, Volgograd, Russia
*nedogodasv@rambler.ru
ФГБОУ ВО «Волгоградский государственный медицинский университет» Минздрава России, Волгоград, Россия
*nedogodasv@rambler.ru
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Volgograd State Medical University, Volgograd, Russia
*nedogodasv@rambler.ru
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